Ghormley first used the term “facet syndrome” in 1933 to refer to a group of symptoms linked to lumbar spine degenerative alterations.
The phrase cervical facet syndrome is used in the literature to describe axial discomfort caused by involvement of the cervical spine’s posterior components.
It was discovered that the facet joints may be the cause of neck pain and cervical facet syndrome is excluded or not considered at all.
A painful illness originating from the cervical spine’s facet (zygapophyseal) joints is known as cervical facet syndrome.
The posterior portion of the vertebrae contains these tiny and paired joints, which allows regulated neck mobility.
Each cervical vertebra contains two facet joints, one superior and two inferiors. The spinal nerves dorsal rami medial branches innervate them.
Epidemiology
Aprill and Bogduk examined the medical records of patients who had complained of neck discomfort for at least six months because of an accident to assess the prevalence of cervical facet joint pain.
Of the 318 patients who were the subject of the investigation, 26% had at least one facet joint that was causing them pain. The incidence of neck discomfort was 4.9% worldwide.
Between 1990 and 2010, the number of disability-adjusted life years increase from 23.9 million to 33.6 million.
The Global load of Disease 2010 Study examined 291 diseases and neck pain ranked fourth place for years lived with disability (YLDs), which measures disability, and twenty-first for total load.
Anatomy
Pathophysiology
The first seven vertebrae make up the cervical spine, which connects the head to the more static thoracic spine and gives it stability and movement.
The cervical spine’s first two vertebral bodies differ significantly from the others. The axis (C2) articulates inferiorly with the atlas (C1) and the occiput (C1) superiorly.
The atlas, in contrast to the other vertebrae, is ring-shaped and lacks a body. The body, known as the odontoid process, or dens has joined C2.
The dens are secured in position by the transverse ligament and articulates with the anterior arch of the atlas through its anterior articular facet.
The joints have an angle of 85° from the sagittal plane and 45° from the horizontal plane.
Etiology
The causes of cervical facet syndrome are as follows:
Degenerative changes
Repetitive stress from poor posture, heavy lifting, or prolonged mobile use
Age-related wear and tear of cartilage
Whiplash injury or cervical trauma
Genetics
Prognostic Factors
Poorer results are linked to chronic discomfort. A slower or less thorough recovery is frequently predicted by higher baseline pain ratings.
Management may become more difficult if pain radiates to the head, shoulder, or upper extremities, if it is linked to secondary nerve irritation.
Ergonomic adjustments, posture correction, and routine physiotherapy enhance long-term results.
Better results are seen in patients who have localized pain, excellent cervical mobility, a positive reaction to diagnostic blocks, shorter symptom duration, and therapeutic adherence.
Clinical History
Cervical facet joint syndrome patients frequently complain of headaches, restricted range of motion (ROM), and neck discomfort.
The posterior neck is the source of the dull and painful ache, which spreads to the shoulder or mid-back. Patients may also disclose a history of prior neck whiplash injuries.
Ice is recommended during the acute phase to reduce local edema and blood flow to cause bleeding.
Painful muscular spasms may be reduced by therapeutic techniques such as electrical stimulation and ultrasound.
While cyclooxygenase (COX-II) inhibitors have been developed as alternative treatments that produce less stomach irritation, nonsteroidal anti-inflammatory medications (NSAIDs) are useful in lowering pain and inflammation.
During this phase, activities for passive range of motion (PROM) and then active range of motion (AROM) in a pain-free range should be started.
To investigate the epidural space, the spine was split in the sagittal plane after methylene blue injections were administered to a few chosen facet joints.
Compared to intra-articular joint blocks, cervical medial branch blocks are easier to execute. The joint may become constricted by degenerative changes, but the medial branch, which is more easily accessible, is situated at the waist of the articular pillar.
The facet joint is denervated using radiofrequency neurotomy, which denatures the nerve’s proteins by forming the medial branch of the dorsal ramus.
Maintain an upright posture with back support to ensure the chair height is adjusted so that the feet rest flat on the ground. To prevent extended flexion or extension, keep an eye on anything at eye level.
Use a supportive cervical pillow and avoid sleeping in the prone position, as it forces cervical rotation.
Patient should not hold the phone between their ear and shoulder.
Patient should try to engage in mild cervical stretches and postural correction exercises.
Proper awareness about cervical facet syndrome should be provided and its related causes with management strategies.
Appointments with specialist and preventing recurrence of disorder is an ongoing life-long effort.
Use of Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
Ibuprofen:
It inhibits inflammatory reactions and pain to reduce prostaglandin synthesis.
Use of Cyclooxygenase (COX-2) Inhibitors
Celecoxib:
The cyclooxygenase-2 (COX-2) enzyme is selectively and noncompetitively inhibited by celecoxib.
Consider cervical fusion only when extensive nonsurgical treatment has failed with extreme caution.
Spondylotic abnormalities on plain films of the spine should not be the basis for surgical fusion because they are often observed in asymptomatic individuals and are not associated with neck discomfort.
use-of-phases-in-managing-cervical-facet-syndrome
By reducing discomfort and inflammation while increasing pain-free range of motion are the objectives of the first phase.
The recovery phase of therapy should begin for patients with cervical facet syndrome once they are almost pain-free.
After achieving complete range of motion without discomfort and a notable gain in strength, patients with cervical facet syndrome are prepared for the last stage of therapy.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and surgical interventional procedures.
The regular follow-up visits with the specialist are scheduled to check the improvement of patients along with treatment response.
Ghormley first used the term “facet syndrome” in 1933 to refer to a group of symptoms linked to lumbar spine degenerative alterations.
The phrase cervical facet syndrome is used in the literature to describe axial discomfort caused by involvement of the cervical spine’s posterior components.
It was discovered that the facet joints may be the cause of neck pain and cervical facet syndrome is excluded or not considered at all.
A painful illness originating from the cervical spine’s facet (zygapophyseal) joints is known as cervical facet syndrome.
The posterior portion of the vertebrae contains these tiny and paired joints, which allows regulated neck mobility.
Each cervical vertebra contains two facet joints, one superior and two inferiors. The spinal nerves dorsal rami medial branches innervate them.
Aprill and Bogduk examined the medical records of patients who had complained of neck discomfort for at least six months because of an accident to assess the prevalence of cervical facet joint pain.
Of the 318 patients who were the subject of the investigation, 26% had at least one facet joint that was causing them pain. The incidence of neck discomfort was 4.9% worldwide.
Between 1990 and 2010, the number of disability-adjusted life years increase from 23.9 million to 33.6 million.
The Global load of Disease 2010 Study examined 291 diseases and neck pain ranked fourth place for years lived with disability (YLDs), which measures disability, and twenty-first for total load.
The first seven vertebrae make up the cervical spine, which connects the head to the more static thoracic spine and gives it stability and movement.
The cervical spine’s first two vertebral bodies differ significantly from the others. The axis (C2) articulates inferiorly with the atlas (C1) and the occiput (C1) superiorly.
The atlas, in contrast to the other vertebrae, is ring-shaped and lacks a body. The body, known as the odontoid process, or dens has joined C2.
The dens are secured in position by the transverse ligament and articulates with the anterior arch of the atlas through its anterior articular facet.
The joints have an angle of 85° from the sagittal plane and 45° from the horizontal plane.
The causes of cervical facet syndrome are as follows:
Degenerative changes
Repetitive stress from poor posture, heavy lifting, or prolonged mobile use
Age-related wear and tear of cartilage
Whiplash injury or cervical trauma
Poorer results are linked to chronic discomfort. A slower or less thorough recovery is frequently predicted by higher baseline pain ratings.
Management may become more difficult if pain radiates to the head, shoulder, or upper extremities, if it is linked to secondary nerve irritation.
Ergonomic adjustments, posture correction, and routine physiotherapy enhance long-term results.
Better results are seen in patients who have localized pain, excellent cervical mobility, a positive reaction to diagnostic blocks, shorter symptom duration, and therapeutic adherence.
Cervical facet joint syndrome patients frequently complain of headaches, restricted range of motion (ROM), and neck discomfort.
The posterior neck is the source of the dull and painful ache, which spreads to the shoulder or mid-back. Patients may also disclose a history of prior neck whiplash injuries.
Ice is recommended during the acute phase to reduce local edema and blood flow to cause bleeding.
Painful muscular spasms may be reduced by therapeutic techniques such as electrical stimulation and ultrasound.
While cyclooxygenase (COX-II) inhibitors have been developed as alternative treatments that produce less stomach irritation, nonsteroidal anti-inflammatory medications (NSAIDs) are useful in lowering pain and inflammation.
During this phase, activities for passive range of motion (PROM) and then active range of motion (AROM) in a pain-free range should be started.
To investigate the epidural space, the spine was split in the sagittal plane after methylene blue injections were administered to a few chosen facet joints.
Compared to intra-articular joint blocks, cervical medial branch blocks are easier to execute. The joint may become constricted by degenerative changes, but the medial branch, which is more easily accessible, is situated at the waist of the articular pillar.
The facet joint is denervated using radiofrequency neurotomy, which denatures the nerve’s proteins by forming the medial branch of the dorsal ramus.
Surgery, Cardiothoracic
Maintain an upright posture with back support to ensure the chair height is adjusted so that the feet rest flat on the ground. To prevent extended flexion or extension, keep an eye on anything at eye level.
Use a supportive cervical pillow and avoid sleeping in the prone position, as it forces cervical rotation.
Patient should not hold the phone between their ear and shoulder.
Patient should try to engage in mild cervical stretches and postural correction exercises.
Proper awareness about cervical facet syndrome should be provided and its related causes with management strategies.
Appointments with specialist and preventing recurrence of disorder is an ongoing life-long effort.
Ibuprofen:
It inhibits inflammatory reactions and pain to reduce prostaglandin synthesis.
Celecoxib:
The cyclooxygenase-2 (COX-2) enzyme is selectively and noncompetitively inhibited by celecoxib.
Consider cervical fusion only when extensive nonsurgical treatment has failed with extreme caution.
Spondylotic abnormalities on plain films of the spine should not be the basis for surgical fusion because they are often observed in asymptomatic individuals and are not associated with neck discomfort.
By reducing discomfort and inflammation while increasing pain-free range of motion are the objectives of the first phase.
The recovery phase of therapy should begin for patients with cervical facet syndrome once they are almost pain-free.
After achieving complete range of motion without discomfort and a notable gain in strength, patients with cervical facet syndrome are prepared for the last stage of therapy.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and surgical interventional procedures.
The regular follow-up visits with the specialist are scheduled to check the improvement of patients along with treatment response.
Ghormley first used the term “facet syndrome” in 1933 to refer to a group of symptoms linked to lumbar spine degenerative alterations.
The phrase cervical facet syndrome is used in the literature to describe axial discomfort caused by involvement of the cervical spine’s posterior components.
It was discovered that the facet joints may be the cause of neck pain and cervical facet syndrome is excluded or not considered at all.
A painful illness originating from the cervical spine’s facet (zygapophyseal) joints is known as cervical facet syndrome.
The posterior portion of the vertebrae contains these tiny and paired joints, which allows regulated neck mobility.
Each cervical vertebra contains two facet joints, one superior and two inferiors. The spinal nerves dorsal rami medial branches innervate them.
Aprill and Bogduk examined the medical records of patients who had complained of neck discomfort for at least six months because of an accident to assess the prevalence of cervical facet joint pain.
Of the 318 patients who were the subject of the investigation, 26% had at least one facet joint that was causing them pain. The incidence of neck discomfort was 4.9% worldwide.
Between 1990 and 2010, the number of disability-adjusted life years increase from 23.9 million to 33.6 million.
The Global load of Disease 2010 Study examined 291 diseases and neck pain ranked fourth place for years lived with disability (YLDs), which measures disability, and twenty-first for total load.
The first seven vertebrae make up the cervical spine, which connects the head to the more static thoracic spine and gives it stability and movement.
The cervical spine’s first two vertebral bodies differ significantly from the others. The axis (C2) articulates inferiorly with the atlas (C1) and the occiput (C1) superiorly.
The atlas, in contrast to the other vertebrae, is ring-shaped and lacks a body. The body, known as the odontoid process, or dens has joined C2.
The dens are secured in position by the transverse ligament and articulates with the anterior arch of the atlas through its anterior articular facet.
The joints have an angle of 85° from the sagittal plane and 45° from the horizontal plane.
The causes of cervical facet syndrome are as follows:
Degenerative changes
Repetitive stress from poor posture, heavy lifting, or prolonged mobile use
Age-related wear and tear of cartilage
Whiplash injury or cervical trauma
Poorer results are linked to chronic discomfort. A slower or less thorough recovery is frequently predicted by higher baseline pain ratings.
Management may become more difficult if pain radiates to the head, shoulder, or upper extremities, if it is linked to secondary nerve irritation.
Ergonomic adjustments, posture correction, and routine physiotherapy enhance long-term results.
Better results are seen in patients who have localized pain, excellent cervical mobility, a positive reaction to diagnostic blocks, shorter symptom duration, and therapeutic adherence.
Cervical facet joint syndrome patients frequently complain of headaches, restricted range of motion (ROM), and neck discomfort.
The posterior neck is the source of the dull and painful ache, which spreads to the shoulder or mid-back. Patients may also disclose a history of prior neck whiplash injuries.
Ice is recommended during the acute phase to reduce local edema and blood flow to cause bleeding.
Painful muscular spasms may be reduced by therapeutic techniques such as electrical stimulation and ultrasound.
While cyclooxygenase (COX-II) inhibitors have been developed as alternative treatments that produce less stomach irritation, nonsteroidal anti-inflammatory medications (NSAIDs) are useful in lowering pain and inflammation.
During this phase, activities for passive range of motion (PROM) and then active range of motion (AROM) in a pain-free range should be started.
To investigate the epidural space, the spine was split in the sagittal plane after methylene blue injections were administered to a few chosen facet joints.
Compared to intra-articular joint blocks, cervical medial branch blocks are easier to execute. The joint may become constricted by degenerative changes, but the medial branch, which is more easily accessible, is situated at the waist of the articular pillar.
The facet joint is denervated using radiofrequency neurotomy, which denatures the nerve’s proteins by forming the medial branch of the dorsal ramus.
Surgery, Cardiothoracic
Maintain an upright posture with back support to ensure the chair height is adjusted so that the feet rest flat on the ground. To prevent extended flexion or extension, keep an eye on anything at eye level.
Use a supportive cervical pillow and avoid sleeping in the prone position, as it forces cervical rotation.
Patient should not hold the phone between their ear and shoulder.
Patient should try to engage in mild cervical stretches and postural correction exercises.
Proper awareness about cervical facet syndrome should be provided and its related causes with management strategies.
Appointments with specialist and preventing recurrence of disorder is an ongoing life-long effort.
Ibuprofen:
It inhibits inflammatory reactions and pain to reduce prostaglandin synthesis.
Celecoxib:
The cyclooxygenase-2 (COX-2) enzyme is selectively and noncompetitively inhibited by celecoxib.
Consider cervical fusion only when extensive nonsurgical treatment has failed with extreme caution.
Spondylotic abnormalities on plain films of the spine should not be the basis for surgical fusion because they are often observed in asymptomatic individuals and are not associated with neck discomfort.
By reducing discomfort and inflammation while increasing pain-free range of motion are the objectives of the first phase.
The recovery phase of therapy should begin for patients with cervical facet syndrome once they are almost pain-free.
After achieving complete range of motion without discomfort and a notable gain in strength, patients with cervical facet syndrome are prepared for the last stage of therapy.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and surgical interventional procedures.
The regular follow-up visits with the specialist are scheduled to check the improvement of patients along with treatment response.
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